Provider Demographics
NPI:1912671926
Name:CASH, JILLIAN TRENT (PTA)
Entity Type:Individual
Prefix:MRS
First Name:JILLIAN
Middle Name:TRENT
Last Name:CASH
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19821 BETHPAGE CT
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-5213
Mailing Address - Country:US
Mailing Address - Phone:540-656-0607
Mailing Address - Fax:
Practice Address - Street 1:44124 WOODRIDGE PKWY
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-6935
Practice Address - Country:US
Practice Address - Phone:703-729-4870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2306605920225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant